Comparative Study of Thulium Fiber Laser Versus Holmium:yttrium-aluminum-garnet Laser for Ureteric Stone Management with Semi-rigid Ureteroscopy: A Prospective, Single-center Study

Overview

Journal Asian J Urol

Specialty Urology

Date 2024 Aug 14

PMID 39139534

Authors

Ankit Gupta

Arvind P Ganpule

Ankush Puri

Abhishek G Singh

Ravindra B Sabnis

Mahesh R Desai

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the efficacy and safety of thulium fiber laser (TFL) and holmium:yttrium-aluminum-garnet (Ho:YAG) laser for ureteric stone management with semi-rigid ureteroscopy.

Methods: In a prospective study from January 2020 to December 2021, we compared 40 patients in each group who underwent semi-rigid ureteroscopic lithotripsy with TFL and that with Ho:YAG laser. Stone volume, stone density, stone fragmentation rates, total lasing time, total operative time, endoscopic vision, retropulsion and stone free rates were analyzed in both groups and compared.

Results: Mean stone volume was comparable in the TFL group and the Ho:YAG laser group (282.45 [standard deviation, SD 139.79] mm 279.49 [SD 312.52] mm; =0.964). Mean stone density was also comparable in the TFL group and the Ho:YAG laser group (1135.30 [SD 317.04] Hounsfield unit 1131.75 [SD 283.03] Hounsfield unit; =0.959). The mean stone fragmentation rates calculated as stone volume divided by lasing time were 25.85 (SD 10.61) mm/min and 21.37 (SD 14.13) mm/min in the TFL group and the Ho:YAG laser group, respectively (=0.113). The mean total lasing time (10.15 [SD] 4.69 min 11.43 [SD 4.56] min; =0.222), mean operative time (25.13 [SD 9.51] min 25.54 [SD 10.32] min; =0.866), and mean total hospital stay (2.62 [SD 0.77] days 2.61 [SD 0.84] days; =0.893) were comparable in the TFL group and in the Ho:YAG group. The vision was better and retropulsion was less in the TFL group. The stone-free rate at 1 month postoperatively was slightly better in the TFL group (100% 90%; =0.095).

Conclusion: TFL technology was associated with the comparable total surgical time, total lasing time, and stone fragmentation rate with Ho:YAG laser. However, TFL had better endoscopic vision, lesser stone retropulsion, and slightly better stone-free rates.

Citing Articles

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